Biomedical subjects

Anne M Stoddard

Publications and source records attributed to Anne M Stoddard.

29 records · Page 2Linked to original sources

PubMed2003

Employed adolescents and beliefs about self-efficacy to avoid smoking.

This paper examines self-efficacy to avoid cigarette smoking and its association with smoking and quitting behavior, peer and worksite influences, nicotine dependence, and socio-demographic variables among employed adolescents. A cross-sectional survey was used to collect data from employed adolescents ages 15-18 who worked in 10 participating grocery stores in Massachusetts. Eighty-three percent of workers (n=379) completed the survey. Results from the multivariate model indicate that daily smokers were less confident in their ability to avoid smoking than those who smoked less frequently. As nicotine dependence increased, self-efficacy beliefs decreased. In addition, as friends' encouragement to quit increased, self-efficacy beliefs also increased. Work-related variables were not associated with self-efficacy beliefs among smokers. This study suggests that smoking frequency, nicotine dependence, and friends' encouragement to quit are associated with self-efficacy to avoid smoking. Researchers may tailor interventions for daily and less-than-daily smokers, build on peer networks that encourage quitting and help smokers resist pressures to smoke, and enhance strategies for coping with nicotine dependence in high-risk situations.

Adolescent↗

PubMed2003

Cancer prevention for working class, multiethnic populations through small businesses: the healthy directions study.

OBJECTIVE: We report demographic and social contextual characteristics of multiethnic, blue-collar workers from the baseline survey of a study conducted in 24 small businesses. We discuss ways in which we incorporated these characteristics into the design of the intervention. METHODS: We used a randomized controled design, with 12 small businesses assigned to a social contextual intervention and 12 to a minimum intervention control condition. The response rates to the survey were 84% at baseline (n = 1717). Primary outcomes included reduction in red meat consumption and increase in physical activity and daily multivitamin intake. Secondary outcomes targeted reduction in smoking and occupational exposures. RESULTS: The majority of the respondents were male (67.6%). This was an ethnically diverse sample with 24.7% representing racial/ethnic groups other than white and 43.6% of participants or their parents born outside of the US. To meet study recommendations, workers needed improvement in all behaviors measured. Participants reported a smoking rate of 25.8, 86.2% ate fewer than 5 servings of fruits and vegetables a day 69.5% ate more than three servings of red meat a week, 46.8% engaged in less than 2.5 h a week and 72.4% reported that they did not consume a daily multivitamin. CONCLUSIONS: Interventions that address the contextual environment in which health behaviors occur, may provide a method that researchers and practitioners can use to reduce health disparities.

Adult↗

PubMed2003

Cancer prevention for working class, multi-ethnic populations through health centers: the healthy directions study.

BACKGROUND: This paper presents the study design and baseline data from Healthy Directions-Health Centers (HCs), a study designed to address social contextual factors in cancer prevention interventions for working class, multi-ethnic populations. This study is part of the Harvard Cancer Prevention Program Project. METHODS: Ten community HCs were paired and randomly assigned to intervention or control. Patients who resided in low income, multi-ethnic neighborhoods were identified and approached for participation. This study targeted fruit and vegetable consumption, red meat consumption, multi-vitamin intake, and physical activity. The intervention components consisted of: (1) a brief in-person study endorsement from the participant's clinician at a scheduled routine care visit; (2) an initial in-person counseling session with a health advisor; (3) four follow-up telephone counseling sessions; (4) multiple mailings of tailored materials; and (5) linkages to relevant activities in the local community. RESULTS: Fifteen percent of the sample smoked, 86% reported eating fewer than five servings of fruits and vegetables per day, 50% reported eating more than the recommended amounts of red meat, 40% did not meet recommended physical activity levels, and 63% did not take a multi-vitamin on a daily basis. Although overall social support was high, participants reported low levels of social norms for the target prevention behaviors. Other social contextual mediators and modifying factors are reported. CONCLUSIONS: By examining the relationships between social contextual factors and health behaviors, it may be possible to enhance the effectiveness of interventions aimed at reducing social inequalities in risk behaviors.

Adult↗

PubMed2003

An exposure prevention rating method for intervention needs assessment and effectiveness evaluation.

This article describes a new method for (1) systematically prioritizing needs for intervention on hazardous substance exposures in manufacturing work sites, and (2) evaluating intervention effectiveness. We developed a checklist containing six unique sets of yes/no variables organized in a 2 x 3 matrix of exposure potential versus protection (two columns) at the levels of materials, processes, and human interface (three rows). The three levels correspond to a simplified hierarchy of controls. Each of the six sets of indicator variables was reduced to a high/moderate/low rating. Ratings from the matrix were then combined to generate a single overall exposure prevention rating for each area. Reflecting the hierarchy of controls, material factors were weighted highest, followed by process, and then human interface. The checklist was filled out by an industrial hygienist while conducting a walk-through inspection (N = 131 manufacturing processes/areas in 17 large work sites). One area or process per manufacturing department was assessed and rated. Based on the resulting Exposure Prevention ratings, we concluded that exposures were well controlled in the majority of areas assessed (64% with rating of 1 or 2 on a 6-point scale), that there is some room for improvement in 26 percent of areas (rating of 3 or 4), and that roughly 10 percent of the areas assessed are urgently in need of intervention (rated as 5 or 6). A second hygienist independently assessed a subset of areas to evaluate inter-rater reliability. The reliability of the overall exposure prevention ratings was excellent (weighted kappa = 0.84). The rating scheme has good discriminatory power and reliability and shows promise as a broadly applicable and inexpensive tool for intervention needs assessment and effectiveness evaluation. Validation studies are needed as a next step. This assessment method complements quantitative exposure assessment with an upstream prevention focus.

Adult↗

PubMed2003

A comprehensive worksite cancer prevention intervention: behavior change results from a randomized controlled trial (United States).

OBJECTIVE: Workplace cancer prevention initiatives have been least successful with blue-collar workers. This study assesses whether an intervention integrating health promotion with occupational health and safety results in significant and meaningful increases in smoking cessation and consumption of fruits and vegetables, compared to a standard health promotion intervention, for workers overall and for blue-collar workers in particular. METHODS: A randomized controlled design was used, with 15 manufacturing worksites assigned to a health promotion (HP) or a health promotion plus occupational health and safety intervention (HP/OHS), and compared from baseline (1997) to final (1999). The response rates to the survey were 80% at baseline (n = 9019) and 65% at final (n = 7327). Both groups targeted smoking and diet; the HP/OHS condition additionally incorporated reduction of occupational exposures. RESULTS: Smoking quit rates among blue-collar workers in the HP/OHS condition more than doubled relative to those in the HP condition (OR = 2.13, p = 0.04), and were comparable to quit rates of white-collar workers. No statistically significant differences between groups were found for mean changes in fruits and vegetables. CONCLUSIONS: Integration of occupational health and safety and health promotion may be an essential means of enhancing the effectiveness of worksite tobacco control initiatives with blue-collar workers.

Adult↗

PubMed2002

Effectiveness of telephone counseling for mammography: results from five randomized trials.

BACKGROUND: Women over age 50 continue to be underscreened for breast cancer. The purpose of this report is to compare the effectiveness of a barrier-specific telephone counseling intervention across the five study sites of the Breast Cancer Screening Consortium (BCSC). METHODS: Each of the BCSC projects was a randomized study of the effectiveness of telephone counseling (TC) in comparison to a control condition. Eligible underusers were identified and surveyed by telephone before and after the implementation of the interventions. Data from a total of 3,461 underusers were analyzed. We tested whether significantly more women randomized to TC than to control were regular mammography users at the follow-up survey. Data were analyzed separately by site. RESULTS: Overall, TC was not significantly more effective than control in encouraging regular mammography. The pooled consortium-wide odds ratio was 1.08 (95% confidence interval: 0.91 to 1.27). CONCLUSIONS: TC has the potential to support maintenance of mammogram use. Modifications are needed to maximize this potential and additional methods should be used in conjunction with TC to reach women who are underusers of mammography.

Aged↗

PubMed2002

Treating nicotine dependence during pregnancy and postpartum: understanding clinician knowledge and performance.

This study investigated the relationship of clinicians' knowledge of treatments for nicotine dependence during pregnancy and postpartum and explored what provider characteristics are associated with knowledge levels. Survey data from community health center (CHC)-based prenatal, pediatric (PED), and WIC program (Special Supplemental Nutrition Program for Women, Infants, and Children) providers participating in a randomized clinical study were used. Providers reported low awareness of the health risks of smoking to the developing fetus/child of pregnant and postpartum women and of the effectiveness of nicotine replacement therapy (NRT) for doubling quit rates. Obstetric (OB) and WIC providers were more aware than PED providers that provider-delivered interventions are effective. Confidence in using counseling steps was significantly associated with general and NRT-related knowledge. NRT-related knowledge, but not general knowledge, was associated with higher performance of intervention steps. Educational programs targeting OB, WIC, and PED providers' knowledge about effective smoking cessation counseling strategies and their confidence in being effective with patients are needed.

Adult↗

PubMed2002

A comprehensive worksite cancer prevention intervention: behavior change results from a randomized controlled trial (United States).

OBJECTIVE: Workplace cancer prevention initiatives have been least successful with blue-collar workers. This study assess whether an intervention integrating health promotion with occupational health and safety results in significant and meaningful increases in smoking cessation and consumption of fruits and vegetables, compared to a standard health promotion intervention, for workers overall and for blue-collar workers in particular. METHODS: A randomized controlled design was used, with 15 manufacturing worksites assigned to a health promotion (HP) or a health promotion plus occupational health and safety intervention (HP/OHS), and compared from baseline (1997) to final (1999). The response rates to the survey were 80% at baseline (n = 9019) and 65% at final (n = 7327). Both groups targeted smoking and diet; the HP/OHS condition additionally incorporated reduction of occupational exposures. RESULTS: Smoking quit rates among blue-collar workers in the HP/OHS condition more than doubled relative to those in the HP condition (OR = 2.13, p = 0.04), and were comparable to quit rates of white-collar workers. No statistically significant differences between groups were found for mean changes in fruits and vegetables. CONCLUSIONS: Integration of occupational health and safety and health promotion may be an essential means of enhancing the effectiveness of worksite tobacco control initiatives with blue-collar workers.

Adult↗

PubMedDate not supplied

Applying a stage model of behavior change to colon cancer screening.

BACKGROUND: There has been limited use of stages of change models in characterizing colorectal cancer (CRC) screening. We assess the applicability of the Precaution Adoption Model (PAPM) by determining the distribution of stages of adoption and by elucidating differences among stages. METHODS: The study is based on 1394 responses (69%) to a survey mailed in 2002 to patients in a primary care population. Survey measures included: self-reported CRC screening, sociodemographic characteristics, health system characteristics, attitudes and beliefs about CRC screening, perceived vulnerability to CRC, and worry about CRC. The main outcome was PAPM stage of adoption of CRC screening based on the ACS preferred guidelines: colonoscopy every 10 years alone or the combination annual FOBT plus sigmoidoscopy every 5 years. RESULTS: 57% were up-to-date with at least one test; 36% were up-to-date with the ACS preferred guidelines; provider recommendation, positive family history of CRC, and positive decisional balance score were significantly associated with higher compared to lower PAPM stages. CONCLUSIONS: The combination of PAPM stage assignment and other factors provides useful information for designing tailored interventions. There are special challenges in developing and interpreting PAPM stage assignments when a guideline offers multiple pathways to adherence and recommends a combination of two tests as a preferred option.

Aged↗

PubMedDate not supplied

Do social influences contribute to occupational differences in quitting smoking and attitudes toward quitting?

PURPOSE: To examine occupational differences in social influences supporting quitting smoking and their relationships to intentions and self-efficacy to quit smoking and to quitting. DESIGN: Data were collected as part of a large worksite cancer prevention intervention trial. SETTING: Forty-four worksites. SUBJECTS: Subjects included 2626 smokers from a total baseline survey sample of 11,456 employees (response rate = 63%). MEASURES: Differences by job category in social support for quitting, pressure to quit smoking, rewards for quitting, and nonacceptability of smoking were measured using mixed model analysis of variance and the Cochran-Mantel-Haenszel test. Their association to self-efficacy, intention to quit, and quitting smoking was assessed using mixed model analysis of variance and linear logistic regression modeling. RESULTS: Compared with other workers, blue-collar workers reported less pressure to quit (p = .0001), social support for quitting (p = .0001), and nonacceptability of smoking among their coworkers (p < .001). Intention to quit was associated with higher levels of social pressure to quit smoking (p = .0001) and social support for quitting (p = .002). Self-efficacy was associated with social pressure to quit (p = .0001), social support for quitting (p = .004), and perceiving greater rewards for quitting (p = .0001). CONCLUSIONS: Although these results are limited somewhat by response and attrition rates, these results suggest that differing social environments may contribute to the differences by occupational category in smoking prevalence and smoking cessation.

Adult↗

PubMedDate not supplied

Work-to-family spillover and fruit and vegetable consumption among construction laborers.

PURPOSE: Spillover is the effect of one role on another as working adults attempt to integrate demands from work and family. We conducted a survey to understand how worker, job, and family characteristics were related to negative work-to-family spillover and how spillover was related to fruit and vegetable consumption to inform intervention design. DESIGN: A combined mail and telephone survey. SETTING: A national random sample in the United States. SUBJECTS: 1108 (44% response) unionized construction laborers. MEASURES: Personal characteristics, job factors, family factors, work-to-family spillover, and fruit and vegetable consumption. ANALYSIS: Multivariable logistic and least-squares regression. RESULTS: A range of 20% to 50% of respondents reported negative work-to-family spillover, agreeing that work demands, time, fatigue, and stress interfered with family meals or food choices. Higher spillover was associated with job factors, being of white race/ethnicity, and having children at home. Lower fruit and vegetable consumption was associated with higher work-to-family spillover (p = .002), being of white race or ethnicity (p < .0001), and working the graveyard or day shift (p = .02). CONCLUSION: Negative experience of work-to-family spillover may link employment to fruit and vegetable consumption and thus to worker health. Understanding the contribution of spillover to fruit and vegetable consumption aids understanding of how work experience affects health.

Adult↗